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Do People With Dementia Know

Know The Signs Of Dementia

How does a person with dementia see the world?

Early diagnosis can help people with dementia plan for the future, and might mean they can access interventions that help slow down the disease. Being familiar with the signs of dementia can help people receive a diagnosis as early as possible.

Early signs that a person might have dementia can include:

  • being vague in everyday conversations
  • memory loss that affects day-to-day function
  • short term memory loss
  • difficulty performing everyday tasks and taking longer to do routine tasks
  • losing enthusiasm or interest in regular activities
  • difficulties in thinking or saying the right words
  • changes in personality or behaviour
  • finding it difficult to follow instructions
  • finding it difficult to follow stories
  • increased emotional unpredictability.

The Effect On Emotions

Although there is a decline in cognitive abilities over time, there is no decline in depth of feeling or the range of emotions that people with dementia experience. Indeed, for many people, emotions appear stronger than ever, and they can express anger, joy, grief and excitement without difficulty. They are also likely to be aware of any emotions expressed by others around them .

Think about your own emotions when caring or providing support for a person with dementia. When you arrive at the home of a person with dementia, are you feeling stressed or rushed after a previous home visit? If so, pause before going into the persons home, relax and smile as you enter. The person will see from your body language and tone of voice how you are feeling. If you are calm, patient, positive and reassuring, you are more likely to be successful in providing help and support.

For more on these sorts of ideas, from the point of view of people with dementia themselves, go to the feature My life is changing because of dementia in the section Getting to know the person with dementia.

How To Deal With Manipulation

Your loved one may have lost the ability to distinguish between truth and falsehoods, and they may no longer have a sense of morality around lying. These symptoms can be especially difficult for a caregiver to handle, as it may feel like a complete change in personality. In fact, a person with dementia may not realize theyre lying.

Manipulation is often the root behavior for trust, control, and security. Sometimes, it can even be a cry for help.

  • Set limits when possible.
  • Remain aware of your personal responses. Do you feel angry, hurt, or frustrated? Acting on these emotions can bring more distress to an already stressful situation.

DONT:

  • Hold dementia behaviors against your loved one.
  • Bring up events to prove or disprove statements.
  • Use accusatory language such as youre lying or youre being manipulative.
  • Engage in heated arguments.

Dealing with dementia behaviors can quickly wear out a caregiver or family member. If you care for a person with dementia and are feeling resentment, anxiety, or depression, dont hesitate to seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.

Although there are no treatments to stop dementia behaviors in the elderly, there are medications, dementia therapies, and memory care communities that may help.

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Anosognosia = Someone Who Doesnt Understand Something Is Wrong

Anosognosia causes someone to not be aware of their health condition. Its common in some cognitive conditions, including Alzheimers.

So, if someone diagnosed with Alzheimers also has anosognosia, they wont know or believe that they have it.

Each person is unique, so the symptoms of anosognosia might vary. Symptoms may also change over time and might even change during a day.

For example, a person might sometimes understand whats going on and other times believe that theyre absolutely fine.

Because of this inconsistent behavior, some family and friends might not even know that theres something wrong even if they do notice that some behaviors seem unusual.

How Might Dementia Affect People Towards The End Of Life

My Home Life

Dementia is progressive, which means it gets worse over time. In the last year of life, its likely to have a big impact on the persons abilities including memory, communication and everyday activities. The speed at which someone will get worse will depend on the type of dementia they have and who they are as an individual.

The symptoms of later stage dementia include the following:

A person with later stage dementia often deteriorates slowly over many months. They gradually become more frail, and will need more help with everyday activities such as eating, dressing, washing and using the toilet. People may experience weight loss, as swallowing and chewing become more difficult.

A person with later-stage dementia may also have symptoms that suggest they are close to death, but continue to live with these symptoms for many months. This can make it difficult for the person and their family to plan for the end of life. It also makes it difficult for those supporting them professionally.

For more information on supporting someone with later stage dementia see Alzheimers Society factsheet, The later stages of dementia .

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Are There Any Treatments

There are treatments that can help with the symptoms of some forms of dementia for a period of time, but there are currently no treatments that slow, halt or reverse the changes in the brain caused by the diseases. There are currently no treatments specifically for vascular dementia or frontotemporal dementia.

In the case of vascular dementia, a doctor may prescribe medication to treat underlying cardiovascular risk factors like high blood pressure or diabetes. Physiotherapy, speech therapy or occupational therapy may be offered to help with speech or movement problems. Non-drug treatments such as cognitive therapies may be available and can help some people with dementia to manage their symptoms.

Alzheimer’s Society has more information on treatments for dementia.

How To Share The Diagnosis

Sharing the initial news of the diagnosis may come from any one of a number of people.

The doctor or specialist, assessment team or members of the family may talk to the person about the diagnosis either individually or as a group.

You might consider having someone present at the time of telling to provide extra support.

Planning ahead about the best way to share the diagnosis will make it easier.

As individual responses will be different, careful consideration must be given to every individual situation.

There are some considerations that will be generally helpful when talking with a person about their diagnosis:

  • Ensure that the setting is quiet and without competing noise and distractions.
  • Speak slowly and directly to the person.
  • Give one message at a time.
  • Allow time for the person to absorb the information and to form questions. Information may need to be added later.
  • Written information about dementia can be helpful to take away and provides a helpful reference. Dementia Australia has information written specifically for people with dementia. In some instances this information is available in video or audio format. Contact the National Dementia Helpline on 1800 100 500.
  • Ensure that someone is available to support the person after being told about the diagnosis.

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Dealing With Dementia Behaviors: Expert Tips For Understanding And Coping

Anger, confusion, and sadness are a few symptoms a person with dementia may experience regularly. The result of these feelings is a range of unpredictable behaviors including using poor judgment, aggression, mood swings, and repeated questioning or manipulation.

Even though you know your loved ones dementia behaviors are symptoms of a disease and not intentional, dealing with them is often emotionally and physically challenging. Learn more about typical dementia behaviors in the elderly and expert tips for managing them.

Do Offer Assurance Often

The person with dementia doesn’t know they have limitations – Anosognosia | Your Questions Answered

Many times, people with dementia may experience feelings of isolation, fear, loneliness or confusion. They may not be able to express this in the right way and thus may wander off or keep saying that they want to go back home, especially if they are in a senior living facility. This is not the time to shut them out. Its a good idea to assure them that they are safe and in a good place.

If you are close enough, provide a comforting hug every once in a while and remind them that they are in a place that has their best interest at heart. Where possible, engage in exercise or take a walk as even light physical activity may help to reduce agitation, restlessness and anxiety.

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S For Communicating With Someone With Dementia

  • Keep yourself in the persons eyeline, and try not to suddenly appear from the side or from behind
  • Speak clearly and in short sentences
  • If the person is struggling to recognise you, introduce yourself and tell them about the connection between you, for instance: Hello mum, its Julie and I have little Danny, your grandson with me.
  • Be reassuring look the person in the eye and smile
  • If a person with dementia is getting agitated, take yourself to another room for a few minutes before coming back in, calmly, and saying something like: Hello, Im back now, how lovely to see you.
  • Try not to correct the person if they get your name wrong or say something that isnt true this can lead to distress and frustration on all sides. Try to imagine how the person with dementia is feeling

Remember, not being recognised does not mean you are totally forgotten.

What Information To Share

As a general guideline a number of things will need to be explained:

  • An explanation as to why the symptoms are occurring.
  • A discussion of the particular form of dementia, in terms that are appropriate to the persons level of understanding.
  • Any possible treatment for symptoms.
  • The specialised services and support programs that are available for people with dementia.

Informing a person that they have dementia is a serious matter, which needs to be handled with great sensitivity and dignity.

It can be a very stressful time for everyone. Dont forget to look after yourself.

Dementia Australia offers confidential counselling and support for families, carers and people with dementia.

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Do Not Try And Alter Undesirable Behavior

Lack of understanding may push one to try and change or stop any undesirable behavior from patients who have dementia. Keep in mind that it is almost impossible to teach new skills or even reason with the patient. Try instead to decrease frequency or intensity of the behavior. For instance, respond to emotion and not the changes in behavior. If a patient insists on always asking about a particular family member reassure them that he or she is safe and healthy as a way of keeping them calm and happy.

Recognising When Someone Is Reaching The End Of Their Life

Do People With Alzheimer

Read about some of the signs that a person with dementia is nearing their death, and how you can support yourself as a carer, friend or relative.

It is important to know when a person with dementia is nearing the end of their life because it can help in giving them the right care. However it can be difficult to know when this time is.

This uncertainty can have a big impact on how the persons family feel, and may also affect how they feel themselves.

There are symptoms in the later stages of dementia that can suggest the person is reaching the final stage of their illness. These include:

It is likely that a person with dementia is nearing the end of their life if they have these symptoms, along with other problems such as frailty, infections that keep coming back, and pressure ulcers .

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Support For People With Dementia And Carers

UCL covid-19 decision aid – a tool to support carers of people living with dementia to make difficult decisions during covid-19

Alzheimers Society end of life care information for patients and families

Alzheimers Society information and fact sheets on all aspects of dementia including what is dementia, types of dementia and living well with dementia

Alzheimer Scotland specialist services for patients and carers

Dementia UK expert one-on-one advice and support to families living with dementia via Admiral Nurses

Do Not Get Angry Or Upset

When looking after persons with dementia, practicing self-control is of utter importance. Learn how to breathe in and just relax without taking things personally or getting angry and upset. Remember that dementia patients do not act the way they do out of their own accord. It is the illness that makes them behave the way they do.

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Signs Of Dying In The Elderly With Dementia

Dementia is a general term for a chronic or persistent decline in mental processes including memory loss, impaired reasoning, and personality changes. Alzheimers disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. It is also the 6th leading cause of death in the United States, and over 5 million Americans are currently living with Alzheimers disease.

Alzheimers disease and most progressive dementias do not have a cure. While the disease inevitably worsens over time, that timeline can vary greatly from one patient to the next.

Caring for a loved one can be challenging and stressful, as the individuals personality changes and cognitive function declines. They may even stop recognizing their nearest and dearest friends and relatives. As dementia progresses, the individual will require more and more care. As a family caregiver, its important to be able to recognize the signs of dying in elderly with dementia. Hospice can help by offering care wherever the individual resides, providing physical, emotional and spiritual care to the patient and support their family.

When Most People Hear The Word Dementia They Think Of Memory Loss

Why do people with dementia lie?

And it does often start by affecting the short-term memory. Someone with dementia might repeat themselves and have problems recalling things that happened recently. But dementia can also affect the way people think, speak, perceive things, feel and behave.

Other common symptoms include:

  • problems planning and thinking things through
  • struggling with familiar daily tasks, like following a recipe or using a bank card
  • issues with language and communication, for example trouble remembering the right word or keeping up with a conversation
  • problems judging distances
  • mood changes and difficulties controlling emotions. For example, someone might get unusually sad, frightened, angry, easily upset, or lose their self-confidence and become withdrawn.

Symptoms of dementia gradually get worse over time. How quickly this happens varies from person to person and some people stay independent for years.

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S For Prompting A Persons Memory

Some people with dementia appear to travel back in time, reliving memories from when they were younger. They might expect grown up children to be small again, or expect their parents to still be alive, or even revert back in their mind to previous marriages or relationships.

There are cues you can use to help the person with dementia make the connections between the past and the present. The following tips may help to do this:

  • Put up photos around the house of important times you were together, such as weddings, birthdays, childrens parties
  • Show the progression of time in these photos, so that they show a spouse or partner when young, but also throughout time and how they appear now
  • Keep a photo album on display with the photos clearly marked with peoples names, the year and the event, following the progression from the past to the present day
  • Wear clothes around the house that the person would associate with you these could include a favourite item of clothing or styles from when you were both younger
  • Wear aftershave or perfume that the person associates with you. If they have a favourite perfume or aftershave, encourage its use often the sense of smell can evoke positive memories when words cannot

Difficulty Completing Normal Tasks

A subtle shift in the ability to complete normal tasks may indicate that someone has early dementia. This usually starts with difficulty doing more complex tasks like balancing a checkbook or playing games that have a lot of rules.

Along with the struggle to complete familiar tasks, they may struggle to learn how to do new things or follow new routines.

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Do Try To Be Pleasant

Caregivers are also humans who are prone to emotions like anger, stress, impatience, and irritation. Even when one goes through caregiver burnout, it is best that the patient does not get wind of it. It is better to step out of the room and try some breathing exercises to calm down before going back to deal with the dementia patient. Where possible, shelve the bad feelings and try and deal with them later. Dementia patients deal with a lot and they do not need more on their plate if they are to lead fulfilling and happy lives.

Symptoms Specific To Frontotemporal Dementia

Do People with Dementia Know They Have It

Although Alzheimer’s disease is still the most common type of dementia in people under 65, a higher percentage of people in this age group may develop frontotemporal dementia than older people. Most cases are diagnosed in people aged 45-65.

Early symptoms of frontotemporal dementia may include:

  • personality changes reduced sensitivity to others’ feelings, making people seem cold and unfeeling
  • lack of social awareness making inappropriate jokes or showing a lack of tact, though some people may become very withdrawn and apathetic
  • language problems difficulty finding the right words or understanding them
  • becoming obsessive such as developing fads for unusual foods, overeating and drinking

Read more about frontotemporal dementia.

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